Dorothy FarrarPulmonary emphysema
Pulmonary emphysema is a condition in which the lungs are overinflated . This overinflation in pulmonary emphysema primarily affects the air sacs in the lungs – the so-called alveoli. Damage to the lungs caused by pulmonary emphysema is irreversible, i.e. it cannot be cured.
What is pulmonary emphysema?
Pulmonary emphysema is assigned to the so-called COPD (chronic obstructive pulmonary disease). Pulmonary emphysema can be hereditary, but it can also result from inflammation and irritation of the lungs.
Various types of pulmonary emphysema are described in medicine. Emphysema can be differentiated in terms of its origin, the course of the disease or its anatomical location in the lungs.
Both asthma and chronic bronchitis can be the cause of pulmonary enphysema. The disease can be diagnosed by a doctor by means of a survey (anamnesis), X-ray examination and computed tomography (CT).
The symptoms and signs of pulmonary emphysema depend on the severity and progression of the pulmonary hyperinflation. Typical symptoms of this disease include shortness of breath, coughing and sputum production. In a specific type of pulmonary emphysema (“blue cough”), the nails and lips take on a bluish-red color due to the lack of oxygen.
causes
There are various causes that can lie behind pulmonary emphysema. The largest proportion of cases of pulmonary emphysema is caused by smoking .Cigarette smoke destroys, among other things, an endogenous enzyme that has a protective function on the lungs – the so-called alpha-1 proteinase inhibitor. Other enzymes attack the lung tissue unhindered due to a lack of balance.
In rare cases, a deficiency in the protective enzyme mentioned can also be congenital – this can also promote pulmonary emphysema. Chronic bronchitis can also lead to pulmonary emphysema due to frequent infections – smokers are also often affected here because of their increased susceptibility to infections.
Pulmonary emphysema can also occur as a work-related illness – for example in glassblowers or musicians with wind instruments: Pulmonary emphysema can occur here due to the high pressure on the lungs.
Occupational pulmonary emphysema can also be caused by constant high exposure to various chemicals or forms of dust that cause permanent irritation of the lungs – for example when working in gravel pits or when processing grain feed. In these cases, those affected usually initially suffer from chronic bronchitis.
symptoms and course
Possible symptoms of pulmonary emphysema:
The first signs of pulmonary emphysema are shortness of breath during physical exertion and a decrease in performance. Pulmonary emphysema is often accompanied by chronic bronchitis . Coughing and sputum production occurs in some patients. Colloquially, this cough is referred to as smoker ‘s cough.
As the disease progresses, when the inflammation in the lungs severely impairs oxygen uptake and the body is no longer sufficiently supplied with oxygen, lips and fingernails take on a bluish discoloration. Over time, the chest expands and balloons, which is caused by the overinflation of the lungs and the permanent contraction of the respiratory muscles. Doctors call this Fasthorax (thorax = chest).
Depending on which symptoms are in the foreground, patients with pulmonary emphysema are divided into two groups: “Pink Buffer” and “Blue Bloater”.
Pink Puffer
Pink puffer means “pink wheezer”. They tend to be slim and suffer particularly from shortness of breath, but have less coughing and no blue discoloration of the lips and nails.
Blue Bloater
Blue Bloater translates to »blue cougher«. In these patients, the cough and the blue discoloration are the main features. They suffer less from shortness of breath, but are prone to right heart failure (weakness of the right ventricle).
Pulmonary emphysema can cause both acute and chronic complications as it progresses. A pneumothorax can form acutely, in which the lungs collapse. It is also possible that there are additional respiratory diseases that make the pulmonary emphysema worse. Heart disease is a chronic complication. Overinflation of the lungs can overload the right ventricle of the heart, which can lead to right heart failure. Tissue destroyed by pulmonary emphysema can no longer regenerate. Once damage has occurred, it remains permanent.
Diagnose
If pulmonary emphysema is suspected, the doctor first asks questions about the patient’s lifestyle and history. He also finds out about complaints that can manifest themselves as shortness of breath, coughing and sputum production as well as general exhaustion.
The medical history is followed by the physical examination. Signs such as difficulty exhaling, a barrel-shaped chest, or enlargement of small veins near the costal arch reinforce the suspicion. Functional tests of the lungs, blood tests and other imaging tests are necessary to ensure the diagnosis of pulmonary emphysema .
A lung function test using spirometry and whole-body plethysmography can be used to determine whether there is hyperinflation or obstruction. The emphysema can also be detected using the diffusion capacity measurement. This test requires the patient to hold their breath for a short time. The doctor receives information about the lung surface via test gases.
Computed tomography ( CT ) is used to visualize emphysema . X-ray examinations or magnetic resonance imaging ( MRI ) can provide further information .
complications
Pulmonary emphysema can lead to both acute and chronic complications. Pneumothorax can occur acutely, in which air gets into the gap between the lung and the pleura (pleural space) due to the bursting of emphysema bubbles and causes the lung to collapse on the affected side. The result is a stabbing pain with severe shortness of breath. In the case of pulmonary emphysema, respiratory infections can also aggravate the situation.
Chronic complications include increasing pressure in the pulmonary vessels, which causes the heart to overload because the high resistance in the pulmonary vessels forces it to pump harder. This can lead to right heart failure (right heart failure). This weakens the right side of the heart and limits pumping. When the heart stops pumping properly, fluid builds up in the legs (oedema), blood pools in the veins in the neck, and there is also a risk of cirrhosis of the liver . Since 90% of pulmonary emphysema is caused by smoking, it is necessary to consistently stop smoking so that the disease does not get any worse and the life expectancy of those affected is significantly reduced.
treatment and therapy
Since an existing pulmonary emphysema cannot be cured, the main goal of therapy is to slow down or alleviate the progression of the disease. An important part of the treatment of pulmonary emphysema is to convince smokers of the importance of not smoking in the future.
If there are infections of the respiratory tract, another goal of therapy is the rapid and effective treatment of these infections in order to counteract chronification. Furthermore, patients affected by pulmonary emphysema have the option of training their respiratory muscles through targeted physiotherapy – this can contribute to compensating for limitations caused by pulmonary emphysema.
A possible therapy for patients with a congenital deficiency of the described enzyme ‘alpha-1 proteinase inhibitor’ consists in the administration of a so-called ‘human alpha-1 proteinase inhibitor’ – the enzyme deficit is supposed to be compensated and the progression of the pulmonary emphysema counteracted can become. Such enzyme administration is usually in the form of a weekly infusion.
In very severe cases of illness, an operation in the form of removal of large blisters of a pulmonary emphysema or even a lung transplant may be necessary.
prevention
Especially for people with a congenital weakness of the enzyme ‘alpha-1-proteinase inhibitor’, a very important preventive measure against pulmonary emphysema is to avoid inhaling harmful substances. These include above all the substances released during active smoking.In general, respiratory tract infections can be counteracted – especially the so-called COPD (chronic obstructive pulmonary disease) – to prevent pulmonary emphysema. COPD can promote pulmonary emphysema.
In order to prevent infections, annual influenza and/or pneumococcal vaccinations are recommended, depending on the patient – the pneumococci are a strain of bacteria that can lead to pneumonia , among other things .
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.